Written Information Security Program (Wisp) For Protection Of Personal Information Template Page 10
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11____________________, INC.
ACKNOWLEDGEMENT AND CERTIFICATION
(Employees and Board Members)
I hereby acknowledge that I have received a copy of the Corporation’s Written
Information Security Program (WISP) and certify that I will comply with the provisions
of the Corporation’s Written Information Security Program and related policies,
procedures, standards and guidelines.
I acknowledge that if I have any questions regarding the Corporation’s WISP or related
policies, procedures, standards or guidelines, it is my responsibility to address those
issues with the Corporation’s Data Security Coordinator for clarification.
I acknowledge that failure on my part to practice due care and due diligence with respect
to Personal Information and the Corporation’s WISP may result in the termination of my
employment or board of directors service for cause.
The terms of this acknowledgement shall survive any termination of employment or
board of directors service.
________________________________________
NAME (PRINTED)
__________________________________________
SIGNATURE
Date: ______________ , 20___
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